HYBRID DEBRANCHING OF THE ARCH VESSELS DURING TEVAR.

A.- Zone 0 open debranching of the supra aortic arch vessels with prosthetic graft, followed by a left common carotid to left subclavian artery bypass, delivery of aortic stent graft into ascending aorta.

B.- Zone 1 right common carotid artery to left subclavian artery retropharyngeal bypass with reimplantation of left common carotid artery, followed by delivery of aortic stent graft into the aortic arch. 

C.-  Zone 0 endovascular debranching of the supra aortic arch vessels, right common carotid artery to left subclavian artery retropharyngeal bypass with reimplantation of left common carotid artery, snorkel technique with simultaneous delivery of innominate artery covered stent and aortic stent graft into ascending aorta. 

D.- Zone 1 endovascular debranching of the supra aortic arch vessels, left common carotid artery to left subclavian artery bypass, snorkel technique with simultaneous delivery of left common carotid artery covered stent and aortic stent graft into aortic arch. 

RUTHERFORD´S VASCULAR SURGERY 2014